COVID-19 news from Annals of Internal Medicine

Below please find link(s) to new coronavirus-related content published today in Annals of Internal Medicine. All coronavirus-related content published in Annals of Internal Medicine is free to the public. A complete collection is available at https://annals.org/aim/pages/coronavirus-content.

1. Currently used SARS-CoV-2 vaccines more than 95% effective in preventing confirmed infection
Free full text: https://www.acpjournals.org/doi/10.7326/M21-1577

A large case-control study of participants in the Veterans Administration (VA) health care system, found that currently used SARS-CoV-2 vaccines are more than 95% effective in preventing confirmed infection. Because veterans are at particularly high risk given their older age and greater burden of comorbidities compared with the general population, these findings should be reassuring. The study is published in Annals of Internal Medicine.

Researchers from VA Pittsburgh Healthcare System studied health records from the VA COVID-19 Shared Data Resource who had SARS-CoV-2 testing between December 2020 and March 2021 to evaluate the short-term effectiveness of vaccines in preventing SARS-CoV-2 infection. For each person who tested positive, a propensity score- and demographic/health characteristic-matched control participant who tested negative was identified. Data on vaccine administration date and the type of vaccine used were also retrieved. The researchers found that 18% of the 54,360 matched pairs of veterans who were vaccinated tested positive for SARS-CoV-2 and 32.8% tested negative. The overall vaccine effectiveness was 97.1% 7 or more days after the second dose. Effectiveness was 96.2% for the Pfizer-BioNTech BNT-162b2 vaccine and 98.2% for the Moderna mRNA-1273 vaccine. Vaccine effectiveness was numerically similar (though statistically significantly higher) among persons aged 70 years or older compared with those younger than 70 years. Effectiveness was similar between Blacks and Whites, men and women, and those with and without higher levels of comorbidities.

According to the authors, these findings clearly show the effectiveness of the current vaccines in preventing infection. Their study did not assess vaccine effectiveness in preventing severe disease and death.

Media contacts: A PDF for this article is not yet available. Please click the link to read full text. The corresponding author, Adeel A. Butt, MBBS, MS, can be reached through Alanna Caffas at Alanna.Caffas@va.gov.

2. Having sickle cell disease quadruples risk for COVID-19-related hospitalization and doubles risk for COVID-19-related death
Free full text: https://www.acpjournals.org/doi/10.7326/M21-1375

A large cohort study found that having sickle cell disease quadrupled a person's risk for COVID-19-related hospitalization and more than doubled the risk for COVID-19-related death. Having sickle cell trait was also associated with increased risks for both outcomes, albeit to a lesser extent. The findings are published in Annals of Internal Medicine.

Researchers from the University of Oxford, Oxford United Kingdom studied a national patient-level database of linked electronic health care records to evaluate the risks for COVID-19-related hospitalization and death in children and adults with sickle cell disorders. The cohort included 5,059 persons with sickle cell disease and 25,682 with sickle cell trait with data observed from January 2020 to September 2020 for hospitalizations and January 2020 to January 2021 for deaths. The researchers found that children with sickle cell disorders had 5 COVID-19-related hospitalizations and no deaths. Adults with sickle cell disease had 40 hospitalizations and 10 deaths. Persons with sickle cell trait had 98 hospitalizations and 50 deaths. The authors note that several aspects of sickle cell phenotypes overlap with the pathophysiology of severe COVID-19, warranting future study.

Given that sickle cell disease affects approximately 15,000 persons in the United Kingdom, 100,000 persons in the United States, and 8 million to 12 million persons globally, the authors suggest that these findings have important implications for informing vaccination strategy and policy decisions.

Media contacts: A PDF for this article is not yet available. Please click the link to read full text. The corresponding author, Ashley Kieran Clift, MBBS, can be reached at communications@phc.ox.ac.uk.

Credit: 
American College of Physicians